Objective To investigate the application value of Lens Thickness (LT) and White-to-White (WTW) when using Barrett Universal II formula (hereinafter referred to as BUII formula) to predict the diopter of intraocular lens (IOL). Methods Single-center, prospective clinical study. Eligible 279 eyes who underwent uneventful phacoemulsification and enVista MX60 implantation by the same surgeon were consecutively enrolled. OA-2000 (Tomey, Japan) non-contact optical biometry was used to measure the ocular data and calculate the IOL implantation power preoperatively. The measured data were substituted into the BUII online formula (APACRS: http://calc.apacrs.org/barrett_universal2105/) with or without the optional parameter LT and WTW to calculate the predicted diopter, and further subgroup analysis was performed according to the patient's axial length. Main outcome measures: the prediction error (PE) and the absolute prediction error (AE) of the formula were observed when the patients were followed up for no less than one month after surgery. All statistical results were analyzed by SPSS 25.0 software. P < 0.05 was considered statistically significant. Results Overall, Ignoring WTW + LT, the median PE was -0.05 D (-0.26, 0.18) (P = 0.011) , with no statistically significant difference in PE for the other parameter combinations compared with 0 (P > 0.05). There was no significant difference in the median AE of each parameter combination (0.22 D - 0.23 D, P = 0.404), and maxAE (+1.5 D) appeared when WTW and LT were omitted simultaneously. When compared between or within the ocular AL subgroups, the percentage of PE ± 0.50 D was higher in the short AL subgroup (80 % VS 66.67 % -73.33 %) and long AL subgroup (77.78 % VS 73.33 % -75.56 %) when LT was omitted. In the medium AL subgroup, the percentage of PE ± 0.50 D was slightly higher when all parameters were included (83.11 % VS 80.82 % - 82.19 %), and slightly lower when WTW + LT was omitted (80.82 %). (P > 0.05 for all comparisons). Conclusion The prediction level of the Barrett Universal II IOL formula with or without substitution of optional parameters was generally good. For eyes with 22 mm ≤ AL < 26 mm, it is recommended to substitute all parameters into the calculation. Omitting both WTW and LT may result in a larger prediction error. For 22 mm ≤ AL < 26 mm eyes, substitution of all parameters is recommended; when AL ≤ 22 mm or AL ≥ 26 mm, the calculation method of only input WTW has higher cumulative accuracy and can be used preferentially.
Modern cataract surgery has entered the era of refractive surgery, and patients' demand for spectacle independence and visual quality is growing day by day. With the development of cataract surgery technology, through detailed preoperative assessment of eye conditions, precise biological measurements, selection of appropriate calculation formulas and types of intraocular lens, and full communication with patients, functional intraocular lenses can achieve good therapeutic effects in proper cataract patients after corneal refractive surgery. This article reports a case of phacoemulsification combined with toric multifocal intraocular lens implantation after LASIK surgery, for cataract surgeons’ reference.
Modern cataract surgery has entered the era of refractive surgery, and patients' demand for spectacle independence and visual quality is growing day by day. With the development of cataract surgery technology, through detailed preoperative assessment of eye conditions, precise biological measurements, selection of appropriate calculation formulas and types of intraocular lens, and full communication with patients, functional intraocular lenses can achieve good therapeutic effects in proper cataract patients after corneal refractive surgery. This article reports a case of phacoemulsification combined with toric multifocal intraocular lens implantation after LASIK surgery, for cataract surgeons’ reference.
Objective The aim of this study was to compare six new generation intraocular lenses. IOL) refractive power calculation formulas (Barrett Universal II [BUII], Emmetropia Verifying Optical [EVO], Hill-Radial Basis Function Accuracy of [Hill-RBF], Kane, Ladas Super Formula [LSF], T2) and traditional formulas (Haigis, Hoffer Q, Holladay 1, SRK/T). Methods The patients received cataract surgery in Optometry Hospital of Wenzhou Medical University from January 2022 to June 2022 were included in this study. Age, sex, axial length (AL), mean keratometry, anterior chamber depth, IOL constant and power, and postoperative refraction results were collected. The prediction accuracy of these ten IOL power calculation formulas was analyzed, including mean prediction error (ME) and its standard deviation, mean absolute prediction error (MAE), median absolute prediction error (MedAE), maximum absolute prediction error (MaxAE), the percentage of eyes of PE within the range of ±0.25D, ±0.5D, ±0.75D, ±1.0D (%±0.25D, %±0.50D, %±0.75D, %±1.00D). Results 506 eyes of 506 patients were included. Kane has the lowest MAE (0.411). %±0.25D of Hill-RBF was the highest (40.91%), %±0.50D or %±0.75D of EVO was the highest (69.37%, 86.17%), and %±1.00D of BUII and Hill-RBF was the highest (94.07%). In general, there are differences in MAE, %±0.50D, %±0.75D, %±1.00D among all formulas (P>0.05).Still, pairwise comparison only found differences between EVO (86.17%), Hill-RBF (85.97%), Kane (85.57%) and Hoffer Q (81.42%) in %±0.75D (all P<0.05). In AL subgroup, the MAE of EVO (0.390), Hill-RBF (0.388), T2 (0.423) and Kane (0.393) in long AL group was different from that of Hoffer Q (0.681) and Holladay 1 (0.654) (all P<0.05), the difference of %±0.50D of EVO (74.47%) compared with Hoffer Q (46.81%) (P=0.017). Conclusion The new generation of IOL power calculation formulas have good accuracy in IOL power prediction, but for eyes with different axial lengths and keratometry, it is necessary to optimize the selection of formula to further improve the prediction accuracy.
Objective: To summarize the establishment and safety management methods of ambulatory strabismus surgery that can provide the basis for carrying out ambulatory surgery nursing under general anesthesia. Methods: We carried out ambulatory surgery management that reformed nursing management model and delivered the integration of medical care in 9 570 patients undergoing strabismus surgery under general anesthesia from October 2015 to October 2018. In implementation process, we carefully managed the patients before and after operation including performing preoperative assessment and health education in advance, strengthening the verification system, strictly monitoring vital signs of the patients, strict shifting state of patients after operation, providing postoperative guidance to patients and their families, and performing follow-up clinic visits after leaving the hospital. Results: No surgical complications occurred in any of our cases. 34 patients had postoperative discomfort, accounting for 0.36%. Among these 34 patients, 2 had dizziness, 2 had urinary retention and 30 hadnausea and vomiting. After treatments, all patients were discharged on schedule. The number of nurses reduced from 16 to 12 that fell by 25%. Wait times for operation reduced by 8 days. Patient satisfaction was improved from 70% to 90%. The mean length of hospital stay was reduced from 3 days to 1 day. Conclusion: The management of ambulatory surgery under general anesthesia is a new medical care service model. Careful planning and strict preoperative and postoperative safety management can ensure the safe implementation of strabismus surgery. Ambulatory surgery under general anesthesia has benefits to save medical resources and improve patient satisfaction.
Dry eye refers to a series of chronic and progressive ocular surface diseases characterized by imbalanced tear film accompanied with ocular discomfort symptoms. The available methods mainly include pharmacotherapy (artificial tears replacement, anti-inflammatory, immunosuppressive therapy) and ophthalmic surgery. P2Y2 receptor agonist is a novel pharmaceutical agent for dry eye treatment, which could stimulate tear fluid secretion and mucin secretion through binding with P2Y2 receptors on the ocular surface, so that improve tear film stability and alleviate symptoms of dry eye. 3% diquafosol ophthalmic solution is the only P2Y2 receptor agonist available for dry eye.
Late-onset toxic anterior segment syndrome (TASS) is a special type of TASS, which has both similarities and differences. With the deepening understanding, more and more late-onset TASS is reported. Late-onset TASS is less common than typical TASS, and the epidemiological characteristics are vary with intraocular lenses. Almost all the factors that can cause typical TASS can cause late-onset TASS, in addition, aluminum element may play a key role in the occurrence of delayed TASS. The clinical manifestations of late-onset TASS are similar to those of typical TASS, with the involvement of the posterior segment more common and hormone therapy effective.
Objective: To compare the operation status and occupational exposure to needle stick injuries level of nursing staff before and after the promotion of nursing standard prevention operation procedure (SOP), and to explore the practicability and effectiveness of nursing SOP. Methods: Before and after the promotion of nursing SOPs at Zhongshan Ophthalmology Center of Sun Yat-sen University, 14 responsible nurses were assessed for operation,and the number of infectious diseases and occupational exposures to needle stick injuries before and after the promotion of nursing SOPs were compared. Results: The average scores of operation and evaluation before and after the implementation of nursing SOP were 82.31 points and 88.23 points, with significant statistical difference(P<0.001). There was no statistical difference in the results of the initial senior responsible nurses. The total number of patients with blood infectious diseases before and after the implementation of nursing SOP was 32 cases and 51 cases. The occupational exposure to needle stick injuries events were 4 cases and 0 and the difference was statistically significant (χ2 =6.698, P=0.020). Conclusion: The promotion of standard preventive procedures can enable caregivers to strengthen self-protection, reduce occupational exposure, and effectively reduce the rate of iatrogenic infection.
Objective: To evaluate the SBAR communication model in the nursing care handover of patients with penetration injuries of eyeball. Methods: Transfer time, receivers’ information retention, and patient’s satisfaction were compared between two groups of patients with penetration injuries of eyeball. A total of 60 patients were handled with the traditional oral communication handover as comparison group and other 60 patients were handled with the SBAR handover as intervention group. Results: When comparing intervention group with comparison group, statistically significant improvements (P<0.05) were observed in all three factors tested. Conclusion:Implementing the communication tool SBAR in the nursing care of patients with penetration injuries of eyeball reduces rate of adverse events, improves patient care quality, enhances transfer efficiency, and boosts patient’s satisfaction.
